A network of Houston health centers serving vulnerable residents has sued the federal government to prevent the loss of funding that local officials say would close six clinics as early as next week.

Central Care Integrated Health Services obtained a temporary restraining order in late December against the U.S. Department of Health and Human Services' acting secretary to extend the terms of an operating grant until Monday. A hearing is set before Chief U.S. District Judge Lee Rosenthal in Houston Monday, and an amended lawsuit filed Jan. 1 seeks to continue federal funding beyond that point.

The upheaval could disrupt the continuity of care for about 10,000 patients in some of Houston's poorest areas, according to Central Care CEO La Toya Darden.

U.S. Rep. Sheila Jackson Lee, D-Houston, who has several clinics in her district, called Wednesday afternoon for continued funding for Houston's first federally qualified health center and publicly requested another review by officials.

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"We think that there is cause to have a reconsideration," the congresswoman said at a news conference, adding that she intends to appeal to the White House and HHS decision-makers.

"That's what we're seeking in the courts, but we're also seeking to sit down at the table and get reconsideration."

She was flanked by physicians, nurses and patients at the Riverside clinic in Third Ward who held "Save Central Care" signs. The organization has been taking care of uninsured and underinsured patients for 25 years.

"There have been no charges of poor care here," Jackson Lee said. "They didn't find fault in the care."

Worried patients

The six Central Care clinics provide primary medical care in underserved areas including Third Ward, Sunnyside, Acres Homes and Humble. The network, which operates under a legal entity named South Central Houston Action Council, became the city's first federally qualified health center when it opened in 1992. The organization is primarily funded by the Health Resources and Services Administration, an HHS agency known as HRSA.

According to HRSA online records, Central Care received $5.376 million for 2017 to provide primary care services. Clinics offer medical, dental and behavioral health services as well as HIV care and prevention.

The grant money for the communities now served by Central Care has been awarded to another provider, who could not be determined immediately Wednesday and was not listed on HRSA's list of 2018 grantees in Harris County. The online data notes that organizations that have received commitments but not awards were not included.

HRSA public affairs officials did not respond immediately to a request for comment.

Central Care sued HHS on Dec. 22 for relief pending a review of its service area competition application. The award went to the "highest-scoring applicant," agency officials said in court documents. Central Care had received grants to operate in the designated service areas since 2002.

Without the grant money, Central Care "would be forced to shutter all six of its facilities," the suit said.

A half-dozen patients attested to the quality of care as people seeking dialysis arrived Wednesday for treatment.

Central Care is the medical home of retiree Ruby Samuel, a brain aneurysm survivor of more than three decades.

"It has become very important to me since that time that I have health care management ... so that I can avoid another," the 71-year-old said. "I am so pleased with the staff. They are very personable, professional and loving."

Anahi Gonzalez, a 29-year-old receptionist, said she receives dental care at the Third Ward clinic.

"Coming from a Hispanic family – mainly immigrant – it's nice to know that everybody is very welcoming," she said, choking up while offering remarks in English and Spanish. "Please do not close the doors of Central Care. You would be affecting, not just my family, but many families."

Challenge underway

In 2015, HRSA suspended Central Care's access to health professionals via the National Health Service Corps until certain conditions were met, according an affidavit of Darden in federal court filings. Physicians, dentists, nurse practitioners and others receive student loan forgiveness to practice in underserved areas.

After Central Care complied with conditions, HRSA took almost a year to return the clinics to active status, Darden's affidavit said.

"As of result of this failure by HRSA, Central Care was unable to recruit doctors from the NHSC from July 2016 to May 2017 despite having satisfied the conditions for eligibility," Darden said.

The revised lawsuit questions whether the successful grant applicant actually obtained a higher score and cites Central Care's lack of access to physicians for its score of 89 out of 100.

The complaint also said the Department of Health and Human Services has taken action to begin to "wind down" Central Care's medical services.

Vindication later without holdover funding will still spell disaster, the lawsuit noted. Even if the grant decision is reversed and the money is restored, Central Care "would not be in a position to resume operations" without continuous funding.

The filing also includes a subpoena for HHS Acting Secretary Eric D. Hargan.

HRSA is the primary federal agency responsible for improving health care for underserved populations, including the economically and medically vulnerable as well as those who are geographically isolated.

According to a Dec. 13 email in court documents from a HRSA official, Central Care was advised to apply for designation as a health center program "look-alike," which is not available for grant funding but is eligible for many of the same benefits.

According to HRSA records, the agency has active grants of $835 million in Texas distributed to 140 organizations. In Harris County, there are active grants totaling $98 million to 19 organizations.